As you’ve probably heard by now, Tom Hanks recently announced that he has type 2 diabetes. Since Hanks has gained and lost weight for various movie roles, doctors quoted in media articles of course blamed his diabetes on “extreme weight fluctuations.” I’m reasonably sure the doctors weren’t suggesting Hanks developed diabetes by becoming a skinny guy for his roles in Philadelphia and Castaway, so what they’re saying is that he developed diabetes by getting fatter for other roles.

Maybe, maybe not. I vote not. His weight may have fluctuated for various movie roles, but I’ve never seen him on screen on thought, “Wow, Tom Hanks is really getting fat.”

According to what I could find online, Hanks beefed up to 225 pounds for his role as a former baseball player in A League of Their Own. That may sound like a lot of weight to carry around, but take a look at a picture of him from that film:

Sure, he’s got some thickness around the belly there, but that’s all it is: some thickness around the belly. We’re not looking at what I’d call an obese guy in that picture. I wouldn’t even call him a fat guy. He looks like what he was portraying in that film: an ex-jock who’s gotten a bit soft. Despite coming across on camera as a guy with a long-and-lean body type, Tom Hanks has more muscle on him than you might think. Here he is again in Castaway, when his character first landed on the island:

Once again, he’s got a belly … but look at the thickness of his arms and legs. His calves are nearly the size of my thighs. There’s a lot of weight in those legs. When I saw that film in a theater and there was a scene of him dancing around to celebrate making fire, I remember being impressed with the size of his leg muscles.

If you’ve seen Castaway (good movie), you know that partway through the film, we suddenly jump ahead in time and are shocked to see a totally ripped Tom Hanks – now as a guy who’s been barely surviving on fish and coconuts for years:

If you’d asked me at the time to guess how much he weighed while shooting that section of the film, I would have said 150 pounds. But Hanks weighed 170 pounds in those scenes. He’s six feet tall, so his BMI at that point was just over 23 – in the middle of the “normal” range, despite having almost no body fat. So once again, we’re talking about a guy who is heavier than he looks, thanks to surprisingly thick muscles.

I don’t think temporarily weighing 225 pounds for a film shot in 2000 is the reason he has diabetes in 2013. According to an article on CNN, here’s what his doctor told him:

“I went to the doctor and he said, ‘You know those high blood sugar numbers you’ve been dealing with since you were 36? Well, you’ve graduated,’ ” Hanks told Letterman. ” ‘You’ve got Type 2 diabetes, young man.’ “

He’s had high blood sugar since age 36? Hanks is 57 now. Around age 36, he was shooting Sleepless in Seattle, Philadelphia and Forrest Gump. Those were all after A League of Their Own, and he was a lean guy in all of them – positively skinny, in fact, for his role as a lawyer with AIDS in Philadelphia.

So clearly it’s possible to be quite lean and still have chronically high blood sugar, which is what leads to type 2 diabetes. Here’s another quote from the CNN article:

The “Forrest Gump” star said his condition is manageable through diet, and Letterman said that he too has high blood sugar.

So David Letterman also has high blood sugar, which would classify him as pre-diabetic. Here’s a picture of him from about a year ago:

Does that look like a fat guy to you? Has David Letterman gone through “extreme weight fluctuations” as part of his career? I don’t think so. That’s why I’m opposed to the CDC, the USDA, the AMA and pretty much all the other health “experts” obsessing about how much people weigh with all their talk about the obesity epidemic. The real epidemic is the number of people walking around with chronically high blood sugar.

I’m happy to report that at least one major media outlet didn’t jump on the “he got diabetes because he was fatter in two movie roles” bandwagon. Here’s a quote from the U.K. Telegraph:

But the link with diabetes isn’t as clear as Hanks, and the doctors who have been wheeled out stateside to support his theory, have made out.

While some studies have suggested that yo-yo dieting might destabilise metabolism and lead to chronic weight gain, with increased risk of heart disease or diabetes, others have been inconclusive. Studies in animals have shown that yo-yo dieting is far better for the body than remaining obese.

Even the link between obesity and Type 2 diabetes isn’t as clear cut as many make out. There are many of relatively normal weight who go on to develop the disease, suggesting that in some cases it can be just “one of those things”.

From his description, it sounds as though Tom Hanks had impaired glucose tolerance (pre-diabetes) for years.

Including long stretches during which he was a lean guy.

I’m glad to hear Hanks plans to manage his diabetes through diet – but I hope it’s not the diet recommended by the American Diabetes Association. If it is, someday we’ll be reading more articles about Tom Hanks suffering from the effects of diabetes. I’d much rather read reviews of many more masterful acting performances yet to come.

Serves as a good reminder that famous people are no more enlightened than the rest of us…just more famous. Rich folks like Letterman, Hanks, and Bill Clinton ought to be able to afford doctors who deliver correct information. But surely they think they are getting the best advice money can buy. And they are right, so ingrained is this inaccurate anti-fat bias in the media, government, and field of medicine.

Insensitive as it may be, I chuckle to think that I have a much greater understanding than those three do of metabolic diseases and their cures without having paid more than about $50 for a bunch of (mostly used) books.

I guess my Netflix subscription through which I found Fat Head also costs money, but I was paying $8/month for that already…

Sure, Bill Clinton can afford to see any doctor he wants. So when he developed heart disease, he consulted with Dean Ornish and Caldwell Esselstyn — two of the most famous doctors who are wrong about animal foods and heart disease.

Having two normal-weigh acquaintances who are treated with anti-anxiety medications for the symptoms of previously diagnosed hypoglycemia really made me think about the hidden danger for not-fat people to get overlooked when it comes to metabolic issues. Many in our society are fat, but many thin ones are far from being healthy.

Indeed. I once read a book titled “How Doctors Think,” in which the author recounted having a fit, trim park ranger show up complaining of stomach discomfort, shortness of breath and dizziness. The doctor told him to go home and stop working so hard. The park ranger returned later and it turned out he’d been having a heart attack. It didn’t occur to the author at the time (as a young doctor) that such a fine physical specimen could have heart disease. That was a bias he learned to overcome.

I once went to urgent care with the symptoms of a heart attack. Turned out to be an anxiety related panic attack. But even after my ekg came back clean I must have been asked 10 times if I used cocaine. Apparently drugs were the only possibility for why ayoung thin guy was having chest pain.

Good on the Telegraph for getting it right. Tom Hanks always struck me as being Mr Careful, the guy who’d follow doctors orders, try to eat “healthy”, work out, not hit the dope or booze too hard. No Jack Nicholson. Certainly not one to follow any fad diets or to refuse to take statins if the quack said his choleric humour needed a purge.

That’s what is so frustrating about the bad advice: conscientious people end up hosing themselves. I have a good friend who’s suffering from some major bone-health problems that I’m convinced are the result of too much jogging and too many low-cal, low-fat, soy-based meatless meals. So thanks to bad advice, she worked extra hard and made lots of sacrifices for the privilege of screwing up her body.

I also saw a recent headline about former president George W. Bush having a nearly blocked artery despite years of exercise. Nobody can accuse that guy of being a couch potato, yet he’s developing heart disease anyway. You would think these sorts of “contradictions” would make doctors/media rethink their usual low-fat healthywholegrains stance, but it just becomes a chance to reiterate the same useless dogma.

I’m glad the internet provides a place for people to bypass the “expert” gatekeepers and make some informed choices for themselves.

It’s easy for them brush aside all contradictions as a matter of genetics. Did everything right (by their definition) and still have heart disease? Bad genetics. Live on bacon and eggs and steaks and have outstanding health markers? Lucky gene club.

Silly Beowulf, it’s those two or three eggs a week that W. ate which contributed towards his blocked artery. If he had only followed Bill Clinton’s example and eaten only one bite of meat once a year on Thanksgiving, his artery might have remained healthy for another 10-20 years.

Speaking of bacon, Tom, I just saw a fantastic report from Medical Daily in the news, based as always on the most rigorous science: headline ‘Eating bacon lowers sperm quality.’ Reading further, I find that men participating in IVF–you know, folks with already impaired sperm quality–who respond to a survey that they eat more than half a portion of processed meat, “such as bacon,” per day have lower sperm quality. No more bacon for anybody now; the results are clear.

Sorry to burst your bubble… Now that the truth is out, I urge you to either discontinue this blog or convert it to a vegan one.

We’ve also just learned that George W. Bush turns out to have heart disease even though he’s always worked hard to keep himself very fit. Diet is key.

I am also a thin type 2 and I have always been active and fit. I have weighed the same my whole adult life and carefully tended to my health. Genetics snuck up on me! My doctor brushed off my concerns every time I went in for a physical because I looked so healthy. I didn’t know enough then, but I sure do now.

Sorry to hear about the diabetes, but at least you know what to do about it.

I wonder if his blood sugar has actually risen or is he now considered diabetic because of the lower standard for diagnosis? My mother has had the same blood sugar readings since the 1950s (fasting levels in the 120s), but because the standards have been lowered, she is now considered a Type 2 diabetic at 84, is on medication and has been told to eat a diet low in fat . Despite the fact that she has carried extra weight her entire adult life, has “high” cholesterol and higher blood sugar numbers, she has never had any indication of heart disease. In fact, she has rarely ever been ill and aside from having 5 babies, she has never been hospitalized. Yet she now has to take medication to control her blood sugar and has been given the requisite Lipitor prescription.

My dad, on the other hand, was always of normal weight and had normal blood sugar and cholesterol numbers. He had a heart attack in his 60s, required bypass surgery in his 70s and died at 82 of complications of advanced prostate cancer. But going by the diagnostic numbers, Dad was healthy and Mom was in constant danger of keeling over.

The most disturbing thing to me is that he has had identifiable blood sugar issues for almost 20 years, and no doubt that he was given conventional advice to especially avoid saturated fat and to eat plenty of whole grains–all the while as they “watched” his blood sugar spiral slowly but steadily out of control. Some sources report he’s a vegetarian. A lot of good that did him.

I’ve heard too many times people say “my blood sugar is a little high, but my doctor is watching it.” Great, that’s a big help!

As someone pointed out, he can afford the best medical advice available. And that’s the best they could do???

Yup, lots of doctors will happily “watch” your blood sugar until it reaches the threshold for diabetes. Then they’ll give you drugs and continue watching.

I really believe Tom Hanks is one of the more intelligent guys in his industry. Hopefully, some little tidbit of info will spark the curiosity to check out “alternative” lifestyle changes that will lead him to our way of thinking. I hope he lives a very long and productive life.

I hope so too. He’s a terrific actor and strikes me as one of the classier people in Hollywood.

I hope he doesn’t use the cookbook that I got an ad for in the mail yesterday. It was a “diabetic” cookbook. It had a big colorful page that folded out with many yummy looking pictures of food. On each picture it told the calories and carbs. Most of the carbs were in the 0-2 range. I thought maybe I might be able to modify the recipes to make them work for me, then I found the sample recipes. As I read through the ingredients I noticed it called for regular sugar, but seemed more concerned with low-fat or fat-free ingredients. First diabetic cookbook that I have ever seen call for regular sugar. Thankfully it had the nutritional information under the recipe also. A “diabetic” recipe with 27g of carbs per serving, and counted as 2 carb choices. Another recipe had 15g of carbs per serving (1 carb choice), or 11g if you used a sugar substitute. The last one was 34g carbs per serving (2.5 carb choices). Seems my brain had initially overlooked the word choice behind carbs. To me that is just down right deceitful to market something like that to diabetics by using carb choices instead of actual carbs. Here is one of them from their website (slightly different than the sample recipe, but close).

I didn’t pay too much attention to this when it came out in the news, but I’m not terribly surprised. I suspect the number of lean people with prediabetes is rather high… but these aren’t the people who are being tested for it.

And that’s exactly the problem. Too much focus on weight, not enough on glucose levels.

I have slight pre-diabetes diagnosed at age 34 with only a slightly elevated weight at the time of the A1C test. Today I have been diagnosed with mild gestational diabetes (28 weeks pregnant) despite me efforts to avoid sugar and cut carbs for most of the pregnancy (had been adding carbs back for the last month because I started loosing weight). I do not fit the stereo type for diabetes at all spent most of my life thin have gained and lost weight reasonably for both of my two previous pregnancy’s. I have a weakness for carbs sadly bread, pasta, and rice but I have reduced my consumption of these alot over the last 10 years. I don’t like sugar very much as a child I drank only water because other things were too sweet, I ate almost no candy, strongly disliked cake and didn’t eat cereal I wonder if I sensed that sugar didn’t work for me as a kid. I grew up in a poor family so even though my Mom made tremendous efforts to feed us healthy foods I had a lower fat and protein diet than might have been best. According to conventional wisdom our diet was perfect growing up, low in refined carbs, high in complex carbs like homemade whole wheat bread and beans. As an adult I sometimes ate junk food but tried to be fairly healthy overall and exercised regularly. So here I am without even eating a standard American diet with blood sugar problems. Seems like I must have a genetic problem with carbohydrate/sugar intolerance (my brothers have not been nearly as careful as I have since leaving home and they are all fine on the sugar front). I have two sister-in-laws with pre-diabetes who don’t fit the stereo type either one of them is a marathon runner!

I hope Tom Hanks talks to a good dietitian like the one I just saw who encourages more fat and protein and limiting carbs severely.

I hope he does too. Congratulations on the pregnancy. Here’s to a healthy bouncing baby.

In terms of threshold Blood Glucose values, you would do well to read Jenny Ruhl’s Blood Sugar 101 site. In particular I’d draw your attention to the page where she uses the American Diabetes Association’s own documents to explain why they consciously set the bar high, to delay diagnosis as long as possible!

Another essential resource if you have Diabetes (Type 1 or 2) or Glucose intolerance, or Pre-Diabetes, or Gestational Diabetes etc.. is Richard K. Bernstein MD. A pioneer in the field who has had Type 1 himself for over 60 years and — having previously trained as an engineer — set out to “fix” himself with what ultimately ended up as a low-carb diet… despite the negative advice of the establishment. He even re-trained as an MD in his 40s just to help get his methods recognised against much opposition.

OK Tom sorry for the cross-site links but these are essential resources for anyone with questions about Diabetes

In terms of all these “Types” of Diabetes (and there are other like MODY. LADA Type 1.5)… you may also be aware that some experts now refer to Alzheimer’s as Type 3 Diabetes. There are strong suggestions that the same underlying metabolic damage that leads to Type 2 can also lead to other debilitating conditions. Once again the solution (or at least early prevention) may be a low-carb diet!

In terms of early prevention I strongly urge anyone who already has concerns about carbohydrate intolerance, raised Blood Glucose or similar, to take action now… don’t wait 20 years for a diagnosis like Tom Hanks. It is far, far easier to lower the water pressure and shore up a dam before it has already burst its banks.

The focus on obesity and the assumption it “causes” Type 2 Diabetes has to do with the observation that at the time of diagnosis up to 80% of those with Type 2 are obese. So obviously 2 + 2 = 5. One leads to the other.. right? Except that they fail to consider the underlying condition which leads to the Type 2 has been building up over many years, if not decades. You weren’t NOT Diabetic yesterday and suddenly are today! Over that same time span of years or decades the excess fat mass was also building up, in all likelihood. Same underlying metabolic condition with two (or more) symptoms — Type 2 and obesity! Add to that hypertension and/or dyslipidemia and you’ve got Metabolic Syndrome.

They will tell you that Type 2 is progressive but fail to consider that this means it can also be slowed. stopped or even reversed (chiefly with diet) especially if action is taken early enough.

OK Tom.. nearly off my soapbox

Just a final couple of notes on Tim Hanks himself and that I had also wondered about his weight changes for various roles. I doubt that is the whole story but I also suspect it may have been part of it. For example look at the recent fuss over Sam Feltham and in particular how quickly his metabolism became deranged on an high-carb junk diet. If Tom did have to quickly gain pounds (fat not lean) how did he do it? I like to have fun with the “all calories are equal” crowd by suggesting that actors really ought to be chugging bottles of olive oil to gain weight… after all fat has over twice the calories per gram of sugar! Funny that they don’t do that tho’…

No worries on the cross-links. That’s partly what comments are for, to share information.

That list is freakin’ hilarious. They mention famous athletes like Carl Lewis (nine-time Olympic champion!) and don’t bother to mention he wasn’t a vegetarian at time. Same for other athletes on the list, now vegetarians but not when they were champions. They mention Ben Franklin, who was only a vegetarian as a young man. (I’ve read his autobiography.) They list the Beatles and don’t mention that one died of cancer, as did another one’s vegetarian wife. Same goes for Bob Marley.

But my favorite line is about how a vegetarian diet can REVERSE DIABETES.

I see Christian Bale was on the list too. Maybe that’s why Bruce Wayne was all crippled up in the last Batman movie. It wasn’t from the years of torture from being Batman. It was the actors weak bones that couldn’t handle the physical requirements and had to be written into the script. LOL, just a silly thought.

Indeed it looks like the standards to include a person on such a web-site are rather loose, even you,Tom, could be qualified to join.

In a past starvation was used to reduce sugar level in diabetics http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062586/, however the treatment was not glorified “The permanently calorie-restricted diet was unpleasant, difficult to maintain, and enervating, with the result that many patients withdrew from the regimen. Observers wondered if such privation was too high a price for a modest extension of poor quality life. Joslin commented retrospectively, “We literally starved the child and adult with the faint hope that something new in treatment would appear…It was no fun to starve a child to let him live” [1].” It is easy to imagine how to use vegetarianism as an “undernourishment therapy”, but the web-site authors skipped all negatives.

Tom also said his doctor told him that if he could just get down to what he weighed in high school his diabetes would be cured. Tom pointed out that he weighed 98 pounds in high school, so that wasn’t going to happen.

He’d have to spend a year in a concentration camp to return to that weight.

Jimmy Moore is also a diabetic, but won’t admit it. He’s gained weight because he stopped exercising and decided to eat 300+ grams of fat per day, with a side of protein. He also most likely has NAFLD and had bragged about ‘pooping out fat’. Obviously, the other end of the spectrum is not so healthy either.

What year did you post this comment? When Jimmy visited us in July, he was at about 225 (at 6’3″) and looked leaner and healthier than I’ve ever seen him.

Don’t get me wrong, I love the doctor-bashing that goes on here (I’m an endocrinologist myself and I feel it’s well deserved), and I’m in your camp on diet, but I think you’re caricaturizing the medical position on obesity a little bit. I think most doctors are well aware that not all obese people are diabetic and vice versa. (It’s also true that 85% of longtime smokers will never get lung cancer.)

But for a person who is predisposed to type 2 diabetes by a confluence of genetic and lifestyle factors, gaining weight is going to increase the chances of the diabetes becoming manifest. Said differently it will “push them over the edge.” Supporting this notion are several diabetes prevention trials done around the world that have shown that weight loss reduces risk of progression from prediabetes to diabetes:

In the US trial linked above, the lifestyle strategy was a low fat, low calorie diet. Same for the Finnish study. In the Indian trial, lifestyle modification was more complex–they recommended cutting refined carbs, sugar AND fat. All of these trials showed benefit for the lifestyle groups. Maybe the results would have been even better had they recommended low carb, I suspect they would have, but the point is, they were able to demonstrate some benefit with the strategies they employed.

I personally follow a low carb diet and recommend it to my patients because I think it is more effective for most people, but if I meet a patient who is having success with another dietary plan (both in terms of weight as well as metabolically–glucose, blood pressure, etc) I don’t advise them to change.

I agree that gaining visceral fat can exacerbate the problem, but considering that Tom Hanks was apparently pre-diabetic even during years when he was quite lean, I don’t think we can blame his current diabetes on getting fatter temporarily for a couple of movie roles.

I’d be curious to know if the low-fat, low-calorie diets used in those studies led to a reduced glycemic load — I can’t tell from the abstract.. When I tried low-cal diets back in the day, I ended up eating less of everything, including carbs.

They did not publish dietary logs in the DPP as it’s known, and in fairness, in addition to dietary recommendations, they also encouraged regular brisk walking of 150 minutes/week. So there’s no way to say precisely why the lifestyle modification arm was successful, and as you say, it may have had nothing to do with low fat or caloric restriction per se. The goal for the lifestyle arm was just to achieve 7% weight loss by way of diet and exercise. Unfortunately, the belief that caloric restriction is the answer for weight loss is so deeply ingrained that I doubt they even considered other dietary strategies.

I’m really happy that Tom Hanks came forward with his diagnosis. As someone that works in the life insurance industry I am constantly amazed at how often people first become diagnosed with Type 2 diabetes during their medical exam. Maybe now with such a high profile individual making this announcement more and more people can understand that we are all at risk.

The film follows Donal – a lean, fit, seemingly healthy 41 year old man – on a quest to hack his genes and drop dead healthy by avoiding the heart disease and diabetes that has afflicted his family.

Donal’s father Kevin, an Irish gaelic football star from the 1960s, won the first of 2 All Ireland Championships with the Down Senior Football Team in 1960 before the biggest crowd (94,000) ever seen at an Irish sporting event.

When Kevin suffered a heart attack later in life, family and friends were shocked. How does a lean, fit and seemingly healthy man – who has sailed through cardiac stress tests – suddenly fall victim to heart disease?